Pathways to Mental Health Services CORE PRACTICE MODEL …

1 Pathways to Mental Health Services core PRACTICE MODEL GUIDECHAPTER 1: INTRODUCTION ..1A. Purpose and Background ..1B. Overview of California s Child Welfare and Mental Health Systems for Children and Families ..5i. California Child Welfare System and Servicesii. California Mental Health System and ServicesC. What Children, Youth and Parents/Families Can Expect in Their Interactions with Child Welfare and Mental Health ..6 CHAPTER 2: THE core PRACTICE MODEL (CPM) ..7A. Definition ..7B. Values and Principles ..8C. Teaming ..12i. Elements of Successful Teamingii. The core PRACTICE MODEL Child and Family Teamiii. Building a Teamiv. Models and Approaches for Team MeetingsD. Trauma-Informed PRACTICE ..16E. PRACTICE Components, Standards and Activities ..17i. Engagementii. Assessmentiii. Service Planning and Implementationiv. Monitoring and Adaptingv. Transition TABLE OF CONTENTSF. S e r v i c e s ..27i. General Array of Servicesii.

2 Specific Services for Katie A. SubclassIntensive Care CoordinationIntensive Home-Based ServicesTherapeutic Foster CareCHAPTER 3: IMPLEMENTING THE core PRACTICE MODEL ..29A. Stages of Implementation ..29B. Components for Implementation ..30C. Developmental Framework for Implementation ..33 REFERENCES ..36 APPENDICES ..38A. California Child Welfare System ..38B. PRACTICE Standards and Activities Matrix ..39C. Glossary of Acronyms and Terms ..46D. Katie A. Settlement Background ..51 ACKNOWLEDGMENTS ..52 1A. PURPOSE AND BACKGROUNDThe purpose of the core PRACTICE MODEL (CPM) Guide is to provide practical guidance and direction for county child welfare and Mental Health agencies, other service providers, and community/tribal partners who will be implementing the CPM when working with children and families involved with child welfare who have or may have Mental Health needs. The CPM guide is the first step in articulating the values, core components, standards of PRACTICE and activities for a cross-system CPM for California.

3 This guide identifies specific required components that support the standards and expectations for PRACTICE behaviors by child welfare and Mental Health staff. It is intended to facilitate a common strategic and practical framework that integrates service planning, delivery, coordination and management among all those involved in working with children involved in multiple service systems. In the future, additional tools and resources that support the integration of the values, core components and PRACTICE standards in day-to-day PRACTICE behaviors for child welfare and Mental Health service delivery will be developed and made available through the Statewide Training and Education Committee and other training and technical assistance resources and venues. In California, PRACTICE is changing with regard to the way child welfare and Mental Health staff and service providers work with children, parents and families who need both child welfare and Mental Health Services and supports.

4 The systems that serve these children and families must work together to improve outcomes for children, youth and families who have Mental Health needs and are involved with child welfare. California counties will be implementing a CPM that provides a framework for integrated PRACTICE for all child welfare and Mental Health agencies, service providers and community/tribal partners working with youth and families. Adoption and implementation of the CPM across child welfare and Mental Health systems will require time, resources, system patience and support at all levels and the involvement of parents, families and youth. The on-going development and refinement of the CPM is critical at all stages of rollout of this MODEL across California and will be supported by a number of state and local strategies and , there has never been a better opportunity to undertake the work of systems transformation. At the State level, both the child welfare and Mental Health systems are committed to system redesign and transformation through current major initiatives such as the Mental Health Services Act, The Affordable Care Act, California s Child and Family Services Review process, the Child Welfare Federal Grant Initiative California Partnership for Permanency (CAPP) and the most recent catalyst is the settlement of the Katie A.

5 V Bonta 1: INTRODUCTIONAll counties, agencies and individuals that serve children and their families in both child welfare and Mental Health will use this PRACTICE CPM is about working together to improve outcomes for child welfare youth and families, a value that California has articulated in both child welfare and Mental Health initiatives over the last several There are striking similarities between the core elements, values and practices embodied in these initiatives, including1: Shared Responsibility - Supporting the safety, permanency, education, Mental Health and overall well-being of children and families requires a shared government and community responsibility. Collaboration - The process by which various stakeholders including groups of individuals and families, citizens, agencies, organizations, and businesses work together to share information, effort and resources in order to accomplish a shared vision.

6 Cultural competence and humility - A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among providers, that enables that system, agency or those providers to work effectively in cross-cultural situations with awareness of and respect for the diverse experiences, customs and preferences of individuals and groups. Child Centered and Family Focused/Driven Systems - The concepts that children have a right to be safe, loved, and nurtured and to live with their families (biological and/or extended) whenever possible; and when that is not possible, to live in a permanent, loving and nurturing family home with caring and committed adults who will be there for a lifetime. This is supported by the belief that Services must be focused on the family with supports that empower families and enhance their ability to access internal and natural community resources. Child centered and family focused/driven Services cross agency boundaries and provide integrated service experiences.

7 Permanency - A concept that incorporates but goes beyond the legal definition of permanency and refers to the importance of youth having at least one sustained relationship in their life with an individual who provides unconditional positive commitment and support. Evidence-Based practices - Evidence-based practices are those that have empirical research supporting their efficacy. Child welfare and Mental Health agree on the importance of using practices that have proven effectiveness; both systems have identified a number of evidence-based practices relevant for use in both systems service delivery. Transparency - The ability to ensure that intentions, decisions and actions related to planning, service delivery, communication and any other behaviors are fully defined and explained in a way that is easily understood, candid and open to families and stakeholders. Disproportionality/Disparity - Disproportionality refers to an under- or overrepresentation of individuals/children of a particular racial or ethnic group experiencing a particular child welfare event or receiving a Mental Health service compared to their representation in the general population that may reflect bias or other conditions beyond the circumstances or facts of the individual situation.

8 Disparity refers to the comparison of information across racial and ethnic groups to better understand how the representation of one group compares to another. Disparate treatment refers to the unequal treatment or Services provided to individuals/children of one ethnic group as compared to those provided to similarly situated individuals/children/families of another ethnic group. Both systems strive to eliminate or reduce both disproportionality and disparate Values and concepts are taken from materials on the current Mental Health and child welfare initiatives. 3 Accountability - The responsibility of individuals and systems to assess and manage performance, self-correct, innovate and enhance their ability to achieve positive outcomes. Both systems are interested in outcome-based performance measures as ways of assessing and managing change will take time, commitment, strong partnerships and effort at all levels, both state and county. The building blocks for this kind of transformation include an active involved community partnership, shared commitment to the PRACTICE MODEL , capacity building, and implementation with effective supports.

9 More about implementation of the CPM is discussed in Chapter Three of this is an introduction to the CPM for the people who will be responsible for building system and community commitment to integrated child welfare and Mental Health PRACTICE , and developing strategies for implementation of the MODEL . The CPM articulates an approach to service delivery with the statewide expectations and parameters needed to promote effective PRACTICE that achieves desired outcomes for children and families within and across CPM guide is also intended to provide initial guidance for direct service staff; those child welfare and Mental Health service providers who provide Services to children, youth and their parents/families who need Services from both systems. While the information in this guide will be supplemented with additional detailed PRACTICE information for direct service staff, it will provide an initial introduction to new and transformative service delivery CPM will be part of a dynamic process that will result in more effective ways of partnering among child welfare, Mental Health and children and families in order to achieve positive outcomes for youth and families who are involved with child welfare and have Mental Health PRACTICE tools, training curriculum, PRACTICE improvement protocols, and quality control systems will further define and support the CPM.

10 As noted above it will be augmented with more detailed materials for front-line staff, as well as for children, youth and families. The California Department of Social Services (CDSS) and the California Department of Health Care Services (DHCS) will develop cross-system training curricula and educational materials for use The CPM is about changing the way one works; from working with children and families in an individual system or agency to working within a team environment to build a culturally relevant and trauma-informed system of supports and Services that is responsive to the strengths and underlying needs of families being served jointly by child welfare and Mental Health . The guide is intended to assist leadership and management in Mental Health and child welfare as they work to implement a comprehensive and integrated approach that children and their families will receive when served jointly by child welfare and Mental Health . This guide is a first step in defining the CPM.